Active NPI
Martine Gneme Zoumanigui
- Dental Therapist
- Deerwood, MN
National Provider Identifier
1801222542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Therapist
- License
- DT21
- Practice address
- 21343 Archibald Road
Deerwood, MN 56444 - Phone
- (218) 534-3141
- NPI assigned
- Sep 25, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Therapist | 125J00000X | DT21 | MN | Primary |
Addresses
Primary practice location
21343 Archibald Road
Deerwood, MN 56444
Mailing address
400 3Rd St S
Apt 120
Sartell, MN 56377-4749
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT21 | MN | MD | Dental Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deerwood Dental, Inc | Past | Accepting new patients | |
| Northland Smiles Corporation PA | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinic/Center
- Deerwood, MN
- NPI 1043567357
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380067200000",
"number": "1801222542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 3RD ST S",
"address_2": "APT 120",
"city": "SARTELL",
"state": "MN",
"postal_code": "563774749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21343 ARCHIBALD ROAD",
"city": "DEERWOOD",
"state": "MN",
"postal_code": "56444",
"telephone_number": "218-534-3141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZOUMANIGUI",
"first_name": "MARTINE",
"middle_name": "GNEME",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-25",
"last_updated": "2013-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "125J00000X",
"taxonomy_group": "",
"desc": "Dental Therapist",
"state": "MN",
"license": "DT21",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deerwood, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.